Self-perceived Role Research Articles

'I've got to go in there with my armour on': Adverse Childhood Experiences Among Adults Who Frequently Attend Emergency Departments.

Frequent presentations to emergency departments contribute to increased service demands and healthcare costs. Literature suggests these adult presentations may be influenced by childhood adversity. This qualitatively driven, mixed methods study explored the self-perceived role of childhood adversity in the health of adults who frequently attended Australian Emergency Departments and their perceptions of the healthcare they received. Data were collected using validated instruments and semi-structured interviews with 12 purposefully sampled adults who frequently attended emergency departments. Qualitative data were analysed using interpretive phenomenological analysis. Three major themes were identified-The experience of childhood adversity: articulating challenges related to childhood trauma, and the subsequent impacts on participants' health, behaviours, relationships and sense of control; Pursuing safety: exploring action participants took to keep themselves and others safe, with this requirement extending into adulthood and influencing Emergency Department presentations; and Seeking humanising healthcare: identifying challenges participants experienced while seeking care in the Emergency Department. Participants perceived their mental health to be profoundly affected by their past experiences of trauma, leaving them feeling vulnerable at times and more likely to experience re-traumatisation in the Emergency Department. Feelings of stigmatisation during Emergency Department encounters led participants to employ self-protection strategies creating further barriers to recovery. Participants described Emergency Departments as often failing to comprehensively address their healthcare needs. They offered suggestions for more effective care interventions. Findings highlight the need for further research to inform policy and practice when designing and implementing interventions for these adults. Consolidated Criteria for Reporting Qualitative Research (COREQ) guided study reporting.

How secure is the secure base? Romantic attachment, emotion regulation, and psychotherapists' role as secure base figures.

In 1988, Bowlby posited that the emotional availability of psychotherapists in establishing a secure base environment is influenced by their personal relational history. Despite the acknowledged influence of the therapist's attachment on therapeutic processes and outcomes, the therapist's role as a secure base figure has received insufficient attention. This study delves into the connection between psychotherapists' attachment organization and their self-perceived roles as secure base figures within clinical contexts. Additionally, we explore the mediating role of emotion regulation processes in this context. The dataset comprises self-reports from 384 psychotherapists with diverse theoretical orientations. Our analysis reveals both direct and indirect effects of psychotherapists' attachment on the provision of a secure base. Emotion regulation, specifically through the dimension of clarity, emerges as a significant mediator in this relationship. This study offers a distinctive contribution to deepening our understanding of the relational dynamics inherent to psychotherapeutic practice. It sheds light on the nuanced relation between attachment and emotion regulation, influencing the psychotherapist's role as a secure base figure in psychotherapy. The discussion of the results additionally emphasizes key implications for clinical practice and therapists' training.

Anesthesia nurses' self-perceived roles, competencies, and attitudes toward patient safety culture.

This study aimed to explore anesthesia nurses' (ANs) perceptions of roles, competencies, and attitudes towards patient safety culture, along with predictive factors for patient safety culture. The 2021 guidelines from the International Council of Nurses aim to ensure global access to safe surgical and anesthesia care by 2030. However, in Taiwan, the roles and competencies of ANs are still evolving. Many have a limited understanding, posing potential risks to patient safety. A cross-sectional study was conducted, involving ANs from five hospitals within a healthcare foundation. ANs' self-perceived roles and competencies were assessed using a structured questionnaire based on the CanMEDS framework from the International Federation of Nurse Anesthetists. Additionally, data were collected using the Chinese version of the Safety Attitudes Questionnaire. Reporting followed the STROBE guideline. Among 200 ANs, a consensus emerged favored all roles and competencies, with positive attitudes toward patient safety culture. Remarkably, self-perceived competencies, working in regional hospitals, and working in medical centers significantly predicted ANs' attitude toward patient safety culture. The study results can assist ANs in gaining a deeper understanding of their roles and competencies. Considering predictive factors, strengthening ANs' competencies may contribute to enhancing patient safety culture. Our results informed nursing leaders and policymakers in Taiwan and other countries regarding ANs' perceptions of roles and competencies. Nurse managers could consider the specific factors influencing ANs' attitudes toward patient safety culture and make great efforts to develop strategies aimed at enhancing their competencies.

A Qualitative Examination of School Principals’ Self-Perceived Role in School Mental Health Service Implementation

A Qualitative Examination of School Principals’ Self-Perceived Role in School Mental Health Service Implementation

P5: Anesthesia Nurses’ Self-Perceived Roles and Competences and Their Recognition of Anesthesia Specialist Nurses' Roles and Competencies

Objective:Older adults are vulnerable to postoperative delirium after surgery and anesthesia, which may affect their cognitive function and increase depressive symptoms. Anesthesia nurses are dominant in the number of anesthesia medical teams. This study aimed to examine the differences between anesthesia nurses' self- perceived roles and competencies and their recognition of the roles and competencies of anesthesia specialty nurses.Methods:A cross-sectional study was conducted. A structured questionnaire based on a guideline of the International Council of Nurses was designed.Results:The participated anesthesia nurses’ (N=200) scale scores and mean scores for each question on the self-perceived role and competency scales were lower than the scores on their recognition of the roles and competencies of anesthesia specialty nurse scales. Regarding the self-perceived roles, the scholar domain received the lowest score (Mean= 2.99, SD= 1.00), while the self-perceived competencies, the management domain received the lowest score (Mean = 3.81, SD = 0.67). Similarly, the scholar domain received the lowest score (mean = 3.34, SD = 1.068) in recognition of the roles of an anesthetic specialist nurse, while the management domain received the lowest score (mean = 4.18, SD = 0.58) in the recognition of the competencies of an anesthesia specialist nurse. Anesthesia nurses' self-perceived roles were affected by their nursing ladder and the hospital level at which anesthesia nurses work. Their self-perceived competencies were affected by their nursing ladder and salary. In addition, their recognition of the roles as anesthesia specialist nurses was affected by the hospital level at which anesthesia nurses work. The nursing ladder affected their recognition of the competencies of an anesthesia specialist nurse.Conclusion:This study has demonstrated that anesthesia nurses must improve their self-perceptions of their roles and competencies to satisfy the expectations of their roles and competencies as anesthesia specialty nurses. The findings of this study could be used to develop future anesthesia nurse education and training programs to provide better care to elderly patients.

Bureaucratic Beliefs and Representation: Linking Social Identities, Attitudes, and Client Outcomes

Representative bureaucracy theory posits that the demographic makeup of a bureaucracy can affect how policy is implemented, especially when bureaucrats engage in “active representation” or behavior that directly advances the interests of a particular group in society. It is often assumed that active representation is motivated by the unique beliefs, convictions, or affinities experienced by bureaucrats holding particular social identities. But few studies of representative bureaucracy have attempted to directly measure the attitudes of bureaucrats, and even fewer studies examine whether such attitudes are meaningfully linked to policy outcomes. This study examines the social identities, self-perceived roles, and political preferences of local school administrators in Texas. The results confirm a link between bureaucratic managers’ social identities and distributional policy outcomes, while also suggesting that distinctive bureaucratic attitudes (as observed here) can offer at best a partial explanation for why the social identities of bureaucrats are linked to policy outcomes.

Wellbeing leadership: Perceptions of pre-service school leaders

This study explored pre-service school leaders' self-perceived roles as future school leaders in terms of securing the provision of wellbeing. Sixteen pre-service school leaders (participants from MA Education Leadership programs) from 14 countries participated in semi-structured interviews. Data was analyzed using theme-based analysis. Findings suggest that pre-service school leaders: (a) exhibited a narrow understanding of the concept of wellbeing; (b) attributed the role of securing students' wellbeing mainly to school psychologists, counselors and teachers; (c) assumed a greater personal role, if any, towards securing students’ wellbeing, compared to that of teachers, despite showing more knowledge of how to address teacher wellbeing; and (e) did not receive any form of capacity building addressing wellbeing leadership, as part of their leadership preparatory programs.

Addressing knowledge gaps: the key role of community health workers and healthcare providers in human papillomavirus prevention and vaccine uptake in a border community.

The Human Papillomavirus (HPV) is the most common sexually transmitted infection and nearly every person who is sexually active will get HPV at some point in their lifetime without having the HPV vaccine. Healthcare Providers (HCPs) and Community Health Workers (CHWs) play an essential role in promoting the HPV vaccine and providing education about HPV in communities. Three focus groups with CHWs (n = 17) and HCPs (n = 7) were conducted and led by trained facilitators. In addition to participating in the focus group, CHWs and HCPs completed a brief questionnaire. Focus groups were voice recorded and transcribed for qualitative analysis. Independent coders conducted content analysis to identify the salient themes of the focus groups. Several important findings emerged from this study highlighting the barriers to HPV knowledge, gaps in the self-perceived role of HPV cancer prevention, and opportunities to action. Financial, knowledge, patriarchy, behaviors, attitudes, and fears were identified as the perceived patient-related barriers to promoting HPV cancer prevention. Both CHWs and HCPs explained that their female patients are often discouraged by their husbands from seeking out sexual health-related healthcare. Finding suggest the need for community tailored education on HPV and "best practice" trainings for HPV prevention that is applicable to both CHWs and HCPs.

A Grounded Theory of Provider Perspectives Regarding Resident Moves from Permanent Supportive Housing

To address the ongoing supply-demand gap for permanent supportive housing (PSH), Moving On initiatives (MOIs) provide linkage to affordable housing without embedded support services and rental subsidies, as well as short-term transitional case management to support transitions to independent housing. PSH providers mediate outcomes for individuals moving on from PSH by providing appropriate supports and assistance. Yet, little is known about how providers view these moves. This study explores how providers perceive moves from PSH. Individual interviews were completed with PSH providers from seven U.S. agencies. Data was analyzed via a modified grounded theory approach. The data show that organizational support and prior experience with moving on shape providers’ perceptions of resident capacity. These perceptions were associated with gatekeeping and recovery-oriented approaches, which informed providers’ self-perceived role as following or leading residents towards moving on. System-level support and pressure to adopt a moving on mindset may lead more providers to promote independence and autonomy among individuals with histories of homelessness.

Poverty as a legitimate management topic: The student voice

Our research investigates student perceptions of the legitimacy of poverty (SDG 1) in management curricula and students’ self-perceived role in addressing poverty globally. Students affirm the importance of poverty within their curricula, yet as we further investigate, we find that students report low exposure to SDG 1 as well as lower desire for exposure to this SDG relative to the other SDGs. Furthermore, our research finds that students feel that businesses are responsible for acting to reduce poverty, and as business students this means that they see this as a future responsibility of their own. Yet they report low personal agency for poverty alleviation as a student or as a graduate of a management program. We find as well that of the four “voices” we investigated, the faculty voice is the least influential in shaping student commitments to poverty alleviation. Because there is a disconnect between student perception of value and student desire for coverage of poverty in the curricula, we explore new avenues for influence on student perceptions of poverty during their studies.

Perspectives of nutrition and physical activity among families of an Indigenous Birth Cohort: a qualitative analysis exploring the barriers to and facilitators of healthy active living

This is a qualitative description of the perspectives and experiences of 15 mothers from the Indigenous Birth Cohort Study as it relates to barriers and facilitators to building and sustaining healthy active living practices. Our findings illustrate six themes: 1) Systemic reinforcements of a colonial legacy; 2) Self-perceived roles as caregivers to young children; 3) Social support and family support systems; 4) Health histories (personal, family, community); 5) Locally-tailored programs and services; 6) Access to digital resources and technology. Participants also discussed solutions, which we illustrate across individual, program-level, and broader community perspectives. When suggesting or making recommendations for future interventions, programs, or new solutions, it is vital to make considerations through a lens that considers the distal (individual), intermediate (program-level), and proximal (broader community-level) barriers and facilitators for individuals with young families.

German GPs' Self-Perceived Role in the COVID-19 Pandemic: Leadership, Participation in Regional Services and Preferences for Future Pandemic Preparedness.

General practitioners (GPs) played a vital role during the COVID-19 pandemic. Little is known about GPs' view of their role, leadership, participation in regional services and preferences for future pandemic preparedness. This representative study of German GPs comprised a web-based survey and computer-assisted telephone interviewing (CATI). It addressed GPs' satisfaction with their role, self-perceived leadership (validated C-LEAD scale), participation in newly established health services, and preferences for future pandemic preparedness (net promotor score; NPS; range -100 to +100%). Statistical analyses were conducted using Spearman's correlation and Kruskal-Wallis tests. In total, 630 GPs completed the questionnaire and 102 GPs the CATI. In addition to their practice duties, most GPs (72.5%) participated in at least one regional health service, mainly vaccination centres/teams (52.7%). Self-perceived leadership was high with a C-LEAD score of 47.4 (max. 63; SD ± 8.5). Overall, 58.8% were not satisfied with their role which correlated with the feeling of being left alone (r = -0.349, p < 0.001). 77.5 % of respondents believed that political leaders underestimated GPs' potential contribution to pandemic control. Regarding regional pandemic services, GPs preferred COVID-19 focus practices (NPS +43.7) over diagnostic centres (NPS -31). Many GPs, though highly engaged regionally, were dissatisfied with their role but had clear preferences for future regional services. Future pandemic planning should integrate GPs' perspectives.

Family-School-Community Partnerships in an Atayal Village

Governmental and non-profit programs have been providing supplemental learning support for indigenous children in the remote areas of Taiwan. Using the theory of social support networking, this study examines the efforts of the unique non-profit Boyo After-School Tutoring Program and uncovers the self-perceived roles of Boyo tutors in promoting the educational growth of indigenous students in the community. From thematic analysis of indepth interviews with five tutors, several themes emerged: (1) motivation to become a tutor; (2) tutors’ diverse roles/responsibilities; (3) tutors’ obstacles and challenges; and (4) tutors’ perceptions of their contributions and value to their community. Most significantly, the research suggests the effectiveness of practising the concept of “it takes a village to raise a child” that a tribal village which invests in relationships among family, school, and the local community can promote and sustain its educational efforts.

Self-perceived role and knowledge of community pharmacists in organ donation.

Although a majority of North Americans is in favor of organ donation, registration remains challenging. Community pharmacists are highly accessible frontline health care professionals that could contribute to a new common registration donation consent system. The objective of the study was to assess self-perceived professional role and organ donation knowledge of community pharmacists in Quebec. We designed a telephone interview survey using a three round modified Delphi process. Following questionnaires testing, we randomly sampled 329 community pharmacists in Quebec. Following administration, we validated the questionnaire by conducting an exploratory factorial analysis using principal component followed by a varimax rotation and rearranging domains and items accordingly. A total of 443 pharmacists were contacted, 329 provided answers to the self-perception role and 216 of them completed the knowledge questionnaire. Overall, community pharmacists of Quebec had a positive view on organ donation and demonstrated interest in acquiring knowledge. Respondents have identified lack of time and high pharmacy attendance as non-limiting barriers to implementing the intervention. The average score on the knowledge questionnaire was 61.2%. With the implementation of an appropriate education program to address this knowledge gap, we believe that community pharmacists could be key players in registered organ donation consent.

Strategies of Foreign Cultural Communication and Multicultural Coexistence on New Media Platforms The Research based on the Videos of Overseas Student Uploaders on Bilibili

With the development of the multiculturalism, paying attention to the characteristics of foreign cultural dissemination and the coexistence strategy of Chinese and foreign cultures has a certain importance for the effective export of Chinese culture in the new media era.This study takes the seven most influential overseas student uploaders on the new media platform bilibili and the videos they created as the research objects, summarizes the content and characteristics of the videos through a combination of quantitative analysis and qualitative observation, analyzes the effect of foreign cultural communication on the bilibili platform, and takes this as an example to explore the development strategy of foreign cultural communication and multicultural coexistence on the new media platform from a macro perspective. The study found that based on three advantages of "innovative perspective brought by unique role positioning", "accurate grasp of audience's curiosity", and "integration of foreign culture and Chinese culture", overseas student uploaders have transcended the self-perceived role of general foreign culture communicators and regarded themselves as executors of the integration and coexistence of Chinese and Western cultures. At the same time, if a culture wants to use new media platforms to gain recognition and widespread communication in foreign countries, communicators should grasp current international popular news and cultural symbols, build emotional resonance in multicultural communication, and enhance practical innovation in communication contents and forms. Only when communicators actively eliminate prejudices and oppositions between cultures and build bridges for cross-cultural exchanges, can the coexistence and development of multi-culture become more comprehensive and vivid.

Who Moderates on Twitch and What Do They Do?

Volunteer moderators are an increasingly essential component of effective community management across a range of services, such as Facebook, Reddit, Discord, YouTube, and Twitch. Prior work has investigated how users of these services become moderators, their attitudes towards community moderation, and the work that they perform, largely through interviews with community moderators and managers. In this paper, we analyze survey data from a large, representative sample of 1,053 adults in the United States who are active Twitch moderators. Our findings -- examining moderator recruitment, motivations, tasks, and roles -- validate observations from prior qualitative work on Twitch moderation, showing not only how they generalize across a wider population of livestreaming contexts, but also how they vary. For example, while moderators in larger channels are more likely to have been chosen because they were regular, active participants, mods in smaller channels are more likely to have had a pre-existing connection with the streamer. We similarly find that channel size predicts differences in how new moderators are onboarded and their motivations for becoming moderators. Finally, we find that moderators' self-perceived roles map to differences in the patterns of conversation, socialization, enforcement, and other tasks that they perform. We discuss these results, how they relate to prior work on community moderation across services, and applications to research and design in volunteer moderation.

Relationship between Unit-Level Nurses' Expectations from Nursing Assistant Roles and Individual Nursing Assistants’ Information-Sharing Behaviors: A Multilevel Mediation Analysis

This study aimed to investigate the relationship between the expectations of unit-level nurses from nursing assistants (NAs), frequency of individual NAs' information-sharing behaviors with nurses, and the effect of NAs' self-perceived roles on this relationship. NAs provide patient care along with nurses, and their information-sharing behaviors with nurses may be influenced by the expectations of the nurses. Nurses and NAs from 104 integrated community care (sub- and postacute) units were included in this Japanese cross-sectional study conducted from July to September 2018. Nurses' expectations from NAs and the NAs' self-perceived roles and information-sharing frequency were measured. Multilevel mediation analysis was performed for NAs' information-sharing behaviors, such as expressing, asking, providing linguistic responses, and providing feedback. Unit-level nurses' expectations from NAs were associated with the frequency of NAs' asking and responding behaviors with nurses (p<.05), mediated by the NAs' self-perceived roles. The frequency of NAs' expressing behaviors and feedback were also associated with their self-perceived roles (p<.001). High expectations of unit-level nurses from NAs led to better perception by NAs of their roles and led to better information-sharing behaviors. Educating nurses on NAs' roles may improve information-sharing between nurses and NAs that leads to safe and appropriate care to patients.

Detection of Vulnerability of Medical Students to Stress: Selfperceived role of Music Therapy in improving Coping Ability

Background: Medical students have been known to undergo tremendous stress during various stages of the MBBS course; some break down while others can cope with the same.Objective: The study aimed to assess medical students’ vulnerability to stress by identifying alterations in cardiovascular parametersunder stress and their resilience score. It was also aimed to find out the personal view of students in considering music therapy forimproving their stress coping ability or resilience.Methods: Orthostatic and mental stress were imparted in first-year medical students by quick change of posture and reading andpresenting an unknown scientific article within a fixed time, respectively. Cardiovascular parameters were measured by standardtechniques and sources of stress with stress coping strategies and resilience were done by a structured questionnaire. Music therapywas imparted after college hours with Mozart’s Symphony. All data were expressed as Mean +/- SEM and statistical significance wasassessed by using Student’s ‘T’ Test and correlation.Results: 100% of students considered academic factors as the primary source of stress, while 52-60% considered physical, emotionaland social factors. Talking to friends was rated to be the most efficient relieving strategy. The subjects were resilient to a considerableextent and their reaction time was within the normal range. Both orthostatic and mental stress caused increases in the cardiovascularparameters as compared to rest, with mental stress causing more significant changes. Subjective responses showed that 78.3% ratedmusic to be highly effective in improving coping ability.Conclusions: First-year medical students considered academic stress as the most important stress inducer in the first year of theirmedical course. Talking to friends was identified as the most effective stress relieving mode. Both orthostatic and mental stress induced significant increases in cardiovascular parameters, mental stress causing more change than the orthostatic one. The majority of students under study perceived and reported music therapy as an effective means of stress coping.

How Do Family Physicians Perceive Their Role in Providing Pre-exposure Prophylaxis for HIV Prevention?-An Online Qualitative Study in Flanders, Belgium.

Introduction:In Belgium, the provision of pre-exposure prophylaxis (PrEP) for HIV prevention is centralized in specialized HIV clinics. Engaging family physicians in PrEP care could help scale-up its delivery and reach underserved populations. The objective of this study was to gain insight into family physicians' self-perceived roles in providing PrEP.MethodsWe conducted 16 online group discussions with a total of 105 Flemish family physicians, between November 2020 and February 2021. A brief online questionnaire assessed their socio-demographics and experience with sexual health. We analyzed verbatim transcribed data using a grounded theory approach.ResultsDespite limited awareness and experience, participants reported a high willingness to be more actively involved in PrEP care. Four potential roles for the family physician in PrEP care were identified: acting as low-threshold entry point for advice; opportunistic case finding of PrEP candidates; initiating appropriate care for PrEP-eligible clients; and ensuring high-quality follow-up care for PrEP users. Participants framed each of these roles within their current activities and responsibilities as primary care providers. Yet, participants differed in their views on the concrete operationalization of these roles, and in the extent of their involvement in PrEP. Particular challenges were a lack of experience with antiretrovirals, perceived limited exposure to clients at high HIV risk, and a lack of expertise and resources to conduct time-intensive risk assessments and counseling related to PrEP.ConclusionBelgian family physicians demonstrated a keen willingness to be involved in PrEP care, but had differing views on the practical implementation into their practices. Providing tailored training on sexual health and PrEP, and investing in collaboration between primary and secondary care, could optimize the integration of PrEP in the primary care practice.

A Quality Improvement Project to Assess Inpatient Nurse Knowledge and Experience in Working with Patients Who have Opioid Use Disorder

BACKGROUND: Nurses are an essential component of patient care and treatment coordination, poised to provide leadership in the direct care of persons with Opioid Use Disorder (OUD). However, there is a lack of evidence regarding bedside RNs knowledge and experience about persons with OUD. Significance: OUD causes significant morbidity and mortality and is undertreated across settings and populations. Prior UCSF studies determined that about 70% of inpatients with OUD do not receive medication assisted therapy (MAT) for their substance use, mirroring national treatment rates. Implementation: Our study aimed to describe nurses’ self-perceived role adequacy, including knowledge and experience, when caring for patients with OUD. In February 2021, an RN survey was conducted on 4 inpatient units that frequently care for patients with OUD. The survey goal was to determine bedside nurses (a) foundational knowledge regarding the diagnosis of OUD and related treatments, (b) previous OUD education, and (c) experience caring for OUD patients. Results: Of 121 RN survey respondents, most had 6-10 years’ experience (33%); 96% were BSN prepared or higher. Data analysis suggests RNs lack knowledge and experience about how to talk to patients and how to advocate for patients with OUD; 10% said they never received training about OUD; 33% recalled learning about OUD in academic settings; 45% received OUD education less than annually. RNs expressed interest in education about physiological effects related to opioids, available resources, and methods to overcome barriers that impede therapeutic relationships. Conclusion: Selected survey results will guide development of new OUD nursing curriculum. Nurses will have essential roles in reducing OUD-related harms when they possess foundational knowledge regarding: the diagnosis of OUD, health risks associated with OUD, and effective treatments for OUD.